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Background: This study aimed to compare the feasibility of nab‐paclitaxel plus platinum‐based chemotherapy (nabTP) versus paclitaxel plus platinum‐based chemotherapy (TP) with immune checkpoint inhibitors (ICIs) as a neoadjuvant modality for locally resectable esophageal squamous cell carcinoma (ESCC). Methods: Between April 2019 and March 2022, we identified ESCC patients who received neoadjuvant immunotherapy with both nabTP (n = 213) and TP (n = 98) at our institution and Henan Cancer Hospital. The patients in the ICIs‐nabTP and ICIs‐TP groups were pair‐matched (1:1) for tumor location, sex, smoking, drinking, clinical T and N stage. The primary endpoint was the hazard of 30‐day major postoperative complications. Second, logistic models were applied to estimate the risk factors for pathological complete response (pCR) rate. Results: All patients underwent esophagectomy with R0 resection. A statistically significant increase in the risk of developing major pulmonary (odds ratio [OR], 1.182; 95% confidence interval [CI]: 0.530–2.635; p = 0.683), anastomotic (OR, 1.881; 95% CI: 0.607–5.830; p = 0.267), cardiac (OR, 1.000; 95% CI: 0.426–2.349; p = 1.000) complications after neoadjuvant immunotherapy plus nabTP was not observed. The median interval to surgery was 39 days in the ICIs‐nabTP group versus 44 days in the ICIs‐TP group (p = 0.119). There was no 30‐day mortality in each group. However, there was a slight difference in the 30‐day readmission rate (p = 0.043) and the incidence of hydropneumothorax (p = 0.027) between the two groups. The pCR rates of the ICIs‐nabTP and ICIs‐TP group were 36.7 and 21.4%, respectively (p = 0.018). Conclusions: It appears to be feasible to add immunotherapy to nabTP regimen for locally advanced ESCC. Compared with TP, nabTP plus ICIs can achieve a better pCR rate in ESCC. [ABSTRACT FROM AUTHOR]

The application of Building Information Modeling (BIM) in fire protection discipline has been sufficiently proved to be useful, but has encountered many barriers in China. Among which, small- and medium-sized enterprises (SMEs), which are considered sensitive to adoption costs and external funding support, play a critical role in the BIM adoption process in fire protection discipline. Therefore, identifying and analyzing the barriers of BIM application are essential to help small- and medium-sized fire protection enterprises to overcome these barriers. In this study, semantic analysis, which includes word frequency analysis and coword analysis, based on literature review was utilized to identify the main barriers. 20 main barriers, which were classified into software, people, organization, and environment group, were obtained. Then, Interpretive Structural Modelling (ISM) approach and Cross-Impact Matrix Multiplication Applied to Classification (MICMAC) analysis were utilized to hierarchically analyze and categorize the main barriers of BIM application in Chinese SMFEs. The findings revealed that the lack of external support and the lack of BIM laws and regulations applicable to fire protection discipline are the key barriers in general for the application of BIM in SMFEs. For the barriers at the enterprise level, through further analysis and discussion based on barriers in the people and organization clusters, the lack of funding support for proper BIM training and the lack of organization culture support were concluded as the key barriers of BIM application inside the scope of SMFEs. According to 80-20 principle, more effort should be focused on the key barriers to gain maximum management effect. The research result categorizes the barriers for easy intervention of fire protection enterprises' managers and policymakers. It contributes to the nascent studies of BIM application and provides guidance for the application of BIM in fire protection discipline. [ABSTRACT FROM AUTHOR]

With the digital development of the construction industry, a new competence model of CPM (construction project manager) to meet the new requirements is highly needed. However, there is still a paucity of research on CPM competences in the new era, and no new CPM competence model has been constructed. To address this problem, this study uses data mining method to collect 2387 big data of recruitment advertisement in the Chinese construction market between August 2020 and October 2021 to construct a competence model of CPM in the digital era, which is called the Diamond model. The Diamond model consists of nine key competences, among which digital capability is a newly emerging one. The digital capability for CPMs is identified and classified into three levels, i.e., technology, knowledge and management. The requirements from the industry for the digital capability of CPM are mostly at the technology and knowledge levels. The results of the study provide a clear reference for both the demand and supply sides of CPM talents. Based on this, construction enterprises can formulate more accurate recruitment strategies, practitioners can dynamically benchmark themselves to the ever-changing industry needs and education, and training parties can better bridge the talent gap. Furthermore, the introduction of digital capability into the CPM competence system also provides a solid departure point for further follow-up research. [ABSTRACT FROM AUTHOR]

Background: In China, open surgical approaches for esophageal cancer (EC) can be divided into two techniques, the right- and left- transthoracic esophagectomy. Although there is an increasing number of instances that use the right side, the optimal surgical technique remains unclear. Based in a large cancer center with rich experience of both transthoracic side approaches, this study compared the long-term survival of patients treated by these two surgical techniques. Methods: The patients included in this study underwent a right transthoracic esophagectomy (Right, McKeown) or left transthoracic esophagectomy (Left, Sweet, or chest neck dual-incision) for esophageal squamous cell carcinoma (ESCC) between January 2015 and October 2018. The overall survival(OS) rate and perioperative data between the two groups were then retrospectively analyzed. Results: We included 437 patients who underwent Right (n = 202) and Left (n = 235) approaches for ESCC. There was a significantly longer median operative time (250 vs. 190 min, P < 0.001) and longer median postoperative hospital stay (17 vs. 14 days, P < 0.001) in the Right side group. The OS at 5-years was 49.9% in the Right group and 52.45% in the Left group; hazard ratio (HR) (95% CI): 1.002 (0.752–1.337), p = 0.987. Conclusions: For middle thoracic ESCC without suspected lymph node metastasis in the upper mediastinum, the esophagectomy through the Left thoracic approach could achieve the same OS as the Right side, with better short-term outcomes. [ABSTRACT FROM AUTHOR]

Background The objective of this study was to describe a cosmetic skin incision for resection of large anterior mediastinal masses, and to review our experience with this technique. Methods From 1999 to 2010, 55 patients with a diagnosis of large anterior mediastinal masses underwent 'goblet'-shaped skin incision with midline sternotomy. The complications, mortality, details of surgery, and duration of hospital stay were observed from review. Patients were monitored via follow-up for a duration of one year after surgery. Results The mean hospital stay was nine days. Wound complications of infection were observed in one patient. There were no other complications, such as hematoma formation, necrosis of skin flap, split or infection of the sternum. No related mortality was recorded within the 30-day postoperative period. All of the patients verbalized the benefits of this technique, particularly the possibility of wearing open-collared clothing, as a result of the cosmetic chest wall and a camouflaging scar below the angle of Louis. At the follow-up periods, 52 of the patients were found to be well. Three patients did not complete follow-up at our facility. Conclusion Our primary experience with this procedure proved it was safe. The technique allows excellent access to the mediastinum and complete removal of large anterior mediastinal masses that are complicated with adjacent midline cardiovascular structures. This technique also provides a better cosmetic result than the standard vertical incision. [ABSTRACT FROM AUTHOR]